I went for my first physical in 35 years (8th grade football) on 5/5/14. My doctor said my PSA level was elevated (4.5) and put me on antibiotics to rule out any infection. After a month my PSA had actually gone up to 5.1, so I was referred to probably the best Urologist in the Dallas area. My initial PSA with him was down to 4.1, but he was still concerned based on my age (48). He said we could wait a month to see what happened, or schedule a biopsy then. I opted for waiting a month, and when I went back, the PSA was back up to 5.1. We scheduled a biopsy for the following week, and the results came back; 3 of 12 core samples were cancerous (1 was 40%, the other 2 were 20%) with a Gleason score of 3+4 (7a). Based on my age, and the fact that I had had no symptoms what so ever prior to the diagnosis, the doctor recommended removing the prostate completely. He said that if you initially treat with radiation, if there is a recurrence, it limits your choices on what you can do at that time, namely, it pretty much eliminates the possibility of surgery in the future. I opted for the robotic laparoscopic prostatectomy and scheduled it for Sept 8th, just after my 49th birthday. The surgery was simple, and the pathology report showed clear margins, so at this point, the doctors feel they were able to get all of it. It had not extended to any other tissue, so I was lucky.
I'm now about 2 months into recovery, and except for a couple of days of discomfort initially, I have had zero pain through this whole experience. They only issues I'm dealing with now are bladder control and ED. The bladder control is the bigger of the two issues at this point. We have kind of put ED on the back burner for the time being. I was prescribed a daily Cialis dose initially, which was changed to a strong "as needed" dose at my first check up, and we are starting to see some results from that, so good news there. The bladder control is worse than I expected it would be. I use pads during the day, and depends brief at night. I am using about 3-4 pads during the day, and can usually make it through the night with 1 brief. It's the worst when have to walk or stand a lot. If I can sit most of the day, I have had days where I only used 1 pad at work.
The surgeon told me that he expects me to regain full control, and regain adequate erections by the one year mark of the surgery. I guess I had hoped it wouldn't take that long, but in the whole scope of things, it's really not that bad.
Well...5 months on from surgery, and things are getting a lot better. I have struggled for 4-1/2 months with bladder control, but eventually went to a physical therapist and found out I was doing the keagle exercises wrong. Once I knew the right way to do them, it has made a world of difference. Best way to tell if you are doing them right is you flex the muscle you would use to keep from passing gas.
I have been using a pad during the day, and a Depends brief at night. I have only used one of each for about the last month and a half. The pads are mostly dry when I would take it off, and many mornings the brief is dry too (after getting up a couple of times at night), but there are mornings when it is soaked, so going to keep doing that for awhile. Today is actually the first day I have gone to work without a pad. I have been getting home from work at night and taking off the pad, and being around the house in the evenings without a pad, and doing pretty good. So this weekend I went without pads completely, and did just fine.
ED is a different story. I have had some erections that you would classify as about a 5-6 out of 10, and they are not completely usable. Other times they are completely useless. I was on Cialis 5mg daily for a month after the surgery, and then they switched me to 20mg as needed pills. For whatever reason the as needed did very little for me. I think part of it was the planning that needed to take place, and then the "on stage" idea of having to perform. It just wasn't natural. Also, if I drank any alcohol at all, it was a waste of time. The alcohol was enough to counteract any Cialis I had taken. They have now put me back on the 5mg daily and said to do a 5-10mg "bump" when I want to have sex. Hopefully this will help with the ED. I don't think there is great concern at this time. We have been more worried with the bladder control up to this point, and are now focusing more on the ED, so we'll see how it goes.
As for treatment up to this point, I still feel I made the right decision, and wouldn't change a thing so far. At this point it is strange to think back 5-6 months when I was in the middle of planning for surgery and going through the surgery. Life is mostly back to normal, and if we can get the ED under control in the next few months, things will be pretty much back to normal.
Well, it's coming up on 2 years since diagnosis and treatment. At this point life is back to normal. I had a little scare last May where my PSA was measured at 0.06 ng/mL, but the next test was back to <0.05 ng/mL, and my urologist chalked it up to a bad test, or a lazy lab tech. My latest PSA was an ultra-sensitive version that measured <0.015 ng/mL, so no concerns there.
As for side effects; bladder control cleared up at about 6 months or so. I have had no issues, other than an occasional leak when I cough or stand up. Usually it happens when I have waited too long to go to the bathroom and my bladder is extra full. I have not worn a pad in well over a year.
ED lasted a lot longer. I was on 5 mg Cialis daily after the surgery, and continued that for a while. I eventually got to the point where I could get an erection, but couldn't maintain it. The urologist switched me to a 5 mg daily and 10 mg "bump" for when I wanted. This helped some, but still no stamina. I tried a vacuum pump without much luck. I tried the Muse pellets that you insert into your penis, with not much luck. I never tried the injections because I just couldn't bring myself to give myself a shot there. I had about decided that it might not be something that I recovered fully. When I stopped worrying about it it started to improve. I guess the idea of having to "perform" when I applied one of the treatments before sex was just too much mental to make it happen. For the last year or so it has been no problem at all. Erections are probably 90% what they were prior, stamina continues until climax and I can get an erection whenever I want. For the most part, sex is back to normal.
At this point, nearly 2 years into this, I have no second thoughts as to treatment. If I had it all to do over, I would have the surgery again. The side effects were definitely a pain in the butt initially, and took a while to get past, but at this point they are back to normal, and there are days that I don't even think about being a cancer survivor.
Almost three years in and things couldn't be better. PSAs have been undetectable, no leaking or ED, and there are many days I don't even think about it.
Skip's e-mail address is: skip.waisner AT gmail.com (replace "AT" with "@")